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Living with Eczema

Someone with Eczema Baby Managed Returning to Work

Kelly shares on how she managed returning to work!
Kelly shares on how she managed returning to work!

This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Kelly who will be sharing on returning to work, at about the time when her son with eczema was six-month old. Kelly is the founder of Bamboo Bubby, and is a return guest of my blog, see here for her interview on the bamboo bubby sleeping bags.

Marcie Mom: Hi Kelly, thanks for taking part in my new blog series ‘Someone has Eczema’! Let’s start with you sharing a little of your son’s eczema, when did he started to have eczema and how was it at 6-month old and now?

Kelly: Thanks for the opportunity to share my experiences Mei! My son was around 6 months old when we finally found a doctor who put the word eczema to his dry, red and irritated skin and who referred us to a specialist eczema clinic. It wasn’t however something that just started overnight. I remember starting to search pharmacy shelves when he was two weeks old looking for a cream that would take away some of the dryness and irritation. We had also need numerous doctors over this time too who were quite blasé about it and would tell us to just use sorbolene (which made it worse!). I think we tried every other cream known to man in that time too as well as trying every type of formula in the hope of finding one that he would drink, because we thought he was just a ‘difficult drinker’ who fought every single feed, often pushing his bottles out of our hands so hard they’d fly across the room!

It wasn’t until our eczema clinic appointment and after a round of allergy tests showed up an intolerance to cow milk protein, that the link between his milk refusal and his eczema became clear for us. We then went through a process of trying soy formula (this was the worst his skin had ever been), then a couple of prescription ones (which he outright refused) before we tried a goats milk one as a last resort and the change was instant from the first bottle. For the first time in his short little life, he drank a whole bottle instead of us forcing 10mls at a time into him. So we just kept giving him this and after a month or so his skin improved A LOT! We were of course also layering moisturizers on him after every nappy change as the eczema was all over his body, but especially bad on his cheeks, stomach, back and legs.

Now, at 3 years old, he still gets eczema flareups, but we know what to do to control and manage it now. Flareups are now usually caused by sickness, fatigue or seasonal allergies.

Marcie Mom: What were your son’s triggers and were they easy for you to communicate to your caregiver?

Kelly: I think we were very lucky that we discovered his trigger not long after I returned to work and he started at our local childcare centre. They were fantastic about accommodating to his needs and being in the baby room, we took all his milk bottles each day anyway. Our Child Care Centre though is required to have policies and procedures in place to meet local and other legislative requirements, meaning they have a Healthy Eating Policy plus several around medication management. So, once we had a written management plan from the doctor that stated his trigger and that he needed moisturizers applied in a certain way after every nappy change it was a very easy process to communicate his needs. They have a very organized system of keeping track of all the babies various different needs and they did a really wonderful job of ensuring he was looked after in this regard.

Marcie Mom: What was the eczema skin care routine you were using, and was it difficult to get the caregiver to understand and be committed to the same routine?

Kelly: Of course there is probably no one else in the world who would do for your child exactly the same as you would yourself, because that’s what we do as parents for our children, often going above and beyond to feel we’ve done everything and the best possible job! However for us, obtaining the GP Management Plan really was the key to ensure the centre provided as close to what we were doing as possible with the regular application of various moisturizers and to make sure his trigger food was avoided.

The aspect I found the most difficult to deal with though, was the sleep routine (or lack of) that our baby desperately needed, yet due to the eczema and milk intolerance we’d never had a chance to establish at home before then throwing child care into the mix! It was around this time that I made my first sleeping bag for him, which helped the caregivers to know that he wouldn’t be damaging his skin while sleeping.

Marcie Mom: One final question – every mom needs to let go, at some point, of our newborn and especially difficult if the child requires special care. Was there a moment that tugged, pulled or pierced your heart when returning to work?

Kelly: I think there was more than a single moment! For me the hardest part was actually knowing in my heart that returning to work was not the best thing for our family, but that it was unfortunately a financial necessity.

I honestly never contemplated just how difficult it is to manage a condition like eczema on top of my own post-natally triggered condition AND return to work with the stress that this brings too, however I believe that having to ‘do it all’ has strengthened who we are as people and what we now know we can cope with. When I look back over the past three years, I’m now grateful for it all. I’ve learnt a lot about juggling of work, baby, household and about the importance of focusing only on doing what is important and necessary – everything else can wait and does get there eventually – it just takes longer than it used to.

Marcie Mom: Thanks Kelly for sharing your journey on returning to work, we all go through it at different degree and different stages in our life, HUGS!

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Living with Eczema

SOMEONE manages Bathing and After-Bath Skin Care

Read on Julie sharing how she manages bathing and after-bath skin care
Read on Julie sharing how she manages bathing and after-bath skin care

This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Julie C., a married mom, who has had eczema since she was 5 years old and shares how she manages her baths and after-bath skin care. Marcie Mom: Hi Julie, thanks for agreeing to be part of this series! You were sharing with me that your eczema may not be apparent to many, had it been more severe in your childhood?

Julie: Yes, as a child I had very visible eczema patches on my face, arms, and legs. Not only was the eczema painful but the other kids teased me about it. My parents tried to help, but none of the remedies recommended by our doctors worked. Unfortunately, it continued into my teenage years and made it difficult to date. Today, I get lots of compliments about how beautiful my skin is.

Marcie Mom: Were there any difficulties you had managing your bath and the after-bath skin care? And how have you finally figured out a routine that works for your skin?

Julie: Yes, there were. Many soaps and shower gels would burn. Many lotions would burn and make things worse – especially on my face.

For bathing, I use a mild soap which is safe for the face too. If I am having a flare up, plain warm water works best for me until the flare up passes. Sometimes when I feel a flare up coming on, I am able to use a liquid antihistamine to stop it.

As an adult, I’ve come to realize my eczema definitely has environmental triggers; however, for me, stress is big a trigger too. To manage stress, I exercise, eat well, and get enough sleep.

Just by doing a little observation and research, I learned what my environmental eczema triggers are, how to avoid them, and what to do if I accidentally come in contact with them.

One big environmental trigger is clothing. People with eczema may want to avoid red clothing. The red dyes seem to be a trigger. Also, be careful about what you wash your clothes with. Your laundry detergent doesn’t ever completely rinse out of your clothing and it could be contributing to your flare ups. The same thing applies to liquid fabric softeners.

Certain foods can lead to flare ups too. For example, there is a certain brand of spaghetti sauce which causes flare ups for me and my niece.

Marcie Mom: What about cosmetics? Any allergies to any cosmetics and what do you do to minimize any potential eczema flares, especially on the face?

Julie: I don’t have a need for foundation, but I do wear lipstick and it can be hit and miss. Most of the pricier brands seems to be safe; however, I once got an eczema break out on my lips from a specific shade in a brand I frequently use!

Marcie Mom: One final question – do you have a favorite facial mask for your face?

Julie: My facial regimen is surprisingly simple.

No facial masks at this point. For washing I use: a mild soap, sometimes I only wash my face with plain warm water, and sometimes I use a rice scrub for sensitive skin to exfoliate. (Warning: Never exfoliate when you’re in the middle of a flare up!) I always use my hands to wash my face – never a cloth or a sponge. I do not dry my face either. After cleansing, while my face is still wet / damp, I apply a very mild moisturizing lotion or a dot of petroleum jelly.

Marcie Mom: Thanks Julie for taking time to share this with me, and many other ladies out there will surely be able to identify with your routine!

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Doctor Q&A

Doctor Claudia Video – Eczema: Scratching the Surface

Aging Skin Eczema Skin Videos of Dr Claudia Aguirre Neuroscientist

Dr. Claudia Aguirre is a neuroscientist, a TED speaker and creator of Ted Education lessons. She is passionate about skincare, psychodermatology and frequently lectures worldwide. Also check out last week’s video on Aging Skin.


This video showcasing Dr Claudia Aguirre was when she worked at Dermalogica

Marcie Mom: In the video, Doctor Claudia explained atopic dermatitis and that elevated IgE (immunoglobulin E) triggered allergic response in certain people. There is no single cause of eczema identified, and no cure for the condition. It is instead a multi-factorial condition characterized by defective epidermal barrier that is more alkaline and has more enzyme activity that reduces the connectivity of the skin layers. Filaggrin is a protein that aids in the formation of skin layers (do watch the video to see the animated filaggrin) and converts to natural moisturizing factors. Dry skin lacks this normal functioning filaggrin gene, and has been linked to atopic diseases such as eczema, asthma and allergies.

Sweat and Eczema

Marcie Mom: Dr Claudia, in the video you mention that sweat is an irritant for many with eczema.

Can you explain how the chemicals in our sweat can cause the allergic reaction? Shouldn’t our skin be used to our sweat?

Dr Claudia: Well an irritant reaction is not the same as an allergic reaction. I explained that sweat can be irritating to eczema skin, as this epidermal barrier may not be fully functional. This is an interesting question though, as we are still understanding the chemical composition of sweat (be that eccrine or apocrine).

In general, sweat is composed of water, minerals (like sodium and magnesium), lactate, ammonia and various amino acids. It could be one of these compounds, the combination of them, the changing pH of the skin, or even the sweat’s water content that can cause the itching and stinging sensations to some people with Eczema.  Digging deeper, I found an interesting study that suggested the amino acid composition of sweat is similar to the composition of the protein profilaggrin (which is later converted to filaggrin). This is interesting because scientists can study filaggrin by using human sweat as a potential chemical model. In the end, sweat can make eczema skin uncomfortable, so I suggest bringing a cool damp towel to your workout, or maybe spritzing a hydrating spray, instead of rubbing or scratching this sensitive skin.

Aromatherapy, Stress and Eczema

MarcieMom: Stress is also a common trigger for eczema and suggestion such as aromatherapy is mentioned in the video. Out of curiosity, does the aroma work the same way as fragrance in skin care products, which is to be avoided? Or is there a specific type of aromatherapy for those with eczema?

Dr Claudia: No, aroma in skin care products varies widely. What you want to avoid are synthetic fragrances which can cause an irritant or allergenic reaction in the skin. Some people use perfume for years before they get a skin reaction. Aromatherapy typically employs essential oils, which are natural compounds. However these can be quite potent, so a trained professional with a background in aromatherapy should be consulted before any treatment. The act of breathing deeply alone can also reduce stress.

Water in Skincare Products to be Avoided?

MarcieMom: In the video, you also recommended water-free barrier repairing products and oatmeal compress. Is water to be avoided in skin care due to preservatives being required if there is a high water content or is it because the eczema skin ‘loses’ the more liquid product easily? As for oatmeal compress, do explain to us (I’m using oatmeal bath oil, but not sure how an oatmeal compress works).

Dr Claudia: Great question. I suppose it could be both. Paraben alternatives are preservatives that have a greater potential of being irritating than parabens. So ‘paraben-free’ formulations may actually be more irritating. The amount of water lost to a skin care product from the skin is most likely negligible, so I recommend anhydrous barrier-repairing products because they contain silicones to protect skin. Our skin has a lipid (oil) layer, so you want to replenish those oils to ensure a properly working barrier.

Colloidal oatmeal for Eczema

Colloidal oatmeal is a wonderful ingredient for eczema skin. There are many scientific studies on oats and dermatitis – and this should be your eczema skin’s best friend. Look for clinical colloidal oatmeal for best results. The compress is basically a wet wrap. This is used to lock in moisture and keep the actives on the skin. On wet skin, apply oat or other active ingredient, follow with a damp gauze and cover with dry wraps. This dry covering could be pajamas (good for kids), or other dry covering. Alternatively, a colloidal oatmeal masque is a really nice add-on to a skin treatment for hydrating and soothing skin.

Vitamin D and Eczema

Marcie Mom: Vitamin D has been mentioned much to boost immunity and for the skin.

How exactly can one with eczema get vitamin D, and what’s your recommended minutes of sun exposure for those with eczema?

Doctor Claudia: Everyone has different needs, so there is no single recommended amount of sun exposure. I advise those wanting to know to consult with a dermatologist trained in a bit of photobiology. Or you could ask a scientist (they are hard to find!). At a recent conference I met Prof. Brian Diffey, an expert in this field. In a recent paper, he concluded “Messages concerning sun exposure should remain focused on the detrimental effects of excessive sun exposure and should avoid giving specific advice on what might be ‘optimal’ sun exposure”.

Vitamin D is an essential hormone and we all need a good dose of it. So speak to a dietician or doctor to find which vitamin D supplements are good for you and be sun smart!

Marcie Mom: Thanks Doctor Claudia, your explanation is so helpful, as even though we can’t cure eczema – it doesn’t hurt to understand more of it in order to manage it confidently. I’m looking forward to more of your videos!

If you have something to share about the topics covered in this post, share in the comments or send this article to someone who has a similar experience. Your sharing will help others.

Categories
Living with Eczema

SOMEONE has Eczema and managed Beach Holidays

Selena shares on beach holidays with her child with eczema!
Selena shares on beach holidays with her child with eczema!

This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Selena Bluntzer, whose 4-year-old daughter has had eczema since she was 3 months old and share how she manages beach holidays with her family. Selena blogs at AmazingandAtopic.com on her daughter’s multiple food allergies, asthma and eczema.

Marcie Mom: Hi Selena, thanks for taking part in my new blog series ‘Someone has Eczema’! Can you share with us the severity of your daughter’s eczema and what are her triggers?

Selena: I would characterize my daughter’s eczema as mild to moderate.  It’s contained to mostly her hands, yet it flares on her legs, arms and torso, when she ingests an aggravating trigger (food or medication).  In the past, she has had some more severe bouts with staph infections, but things are better, now.  It has definitely improved with age and/or the fact that we’ve learned to control her triggers.  Her biggest triggers are her multiple food allergies.  She is also affected by the weather and I also believe stress affects her, as well.

Marcie Mom: Let’s talk holidays! Is a beach holiday something your family does often? And did you have any worries about how your daughter’s eczema and asthma would change on a beach holiday?

Selena: We live about 3 hours from the beach.  We’ve taken our daughter to the beach 3 times and she is 4 years old.  The first time we took her, we didn’t know about her food allergies, and didn’t know very much about managing her eczema.  We were certainly wondering how the change in environment would affect things.  After learning of her food allergies and asthma, we also needed to figure out how to pack for such a trip.

Marcie Mom: Share with us the preparations that you need to take, from planning the length of car drive, how often to stop and moisturize (or just do so in the car), what to pack – for her skin, and change of clothes? (I always pack three sets of clothes for a day holiday, to keep my daughter fresh and not trigger eczema flare.)

Selena: I guess I will cover our latest trip, for which we were probably the best prepared.  We typically plan to leave very early in the morning, stay one night and leave the following afternoon.  Since we’re dealing with food allergies, eczema and asthma, we always have to pack for all 3 conditions.

For the food allergy issue, we had to pack enough food to feed her for the duration of the trip.  She has multiple food allergies and we cannot count on being able to find safe foods when we travel, nor do we take the risk of letting her eat at restaurants.  We packed her favorite shelf-stable goodies and some perishable items in a large cooler, packed with plenty of ice.  (One time, we stopped for gas and were stranded for a couple of hours when our car battery died.  Most tow trucks do NOT have a place for a child car seat, and it took a while before someone could get our battery “jumped”, so we could get to the shop for a replacement.  It’s always good to have extra allergy-safe snacks on hand, because we can’t just pick up anything at the convenience store, with my daughter’s multiple food allergies.)  We had to pack her antihistamines and epinephrine auto-injectors (EAIs).  We took multiple sets of EAIs with us, because we did not know how far away emergency help would be, should it be needed.  I bought a waterproof carrier so we could take them down to the waterfront.

For her asthma, we packed her rescue inhaler (she was not on a daily medication, at the time), her nebulizer and medications.  We also had a power inverter so we could run the nebulizer inside the car, in case we needed to stop for any unexpected, sudden asthma attacks and were not near an electrical outlet (http://www.amazingandatopic.com/2012/01/reactive-airwayasthma-gear.html).

For her eczema, we packed her ointments, lotions, allergy-safe sunblock, SunSmarties UPF clothing, including water shoes to protect her feet from the hot sand and a hat to protect her scalp ( http://www.amazingandatopic.com/2012/06/upf-50-clothing-great-for-eczematic.html), and hydrocortisone and steroid ointments, for any serious outbreaks/spots.  For the car trip, I dressed her in thin, light clothing, and did the moisturizing before getting in the car.  The drive is just under 3 hours, so we only needed to do so once.  We changed clothes after every activity, and I basically packed two outfits for every activity/part of the day, in case she needed a fresh set.

For our next trip, I plan to take a freshly washed set of sheets with us, for lining the hotel bed.  She didn’t seem irritated by the sheets, or anything, but it just seems like a good idea, since you never know about bed bugs and such.

Marcie Mom: One final question – how did your daughter like the beach and did she swim in the beach water and play with the sand?

Selena: She loved it!  She loved playing in the water and didn’t want to get out, when it was time to go inside.  She really enjoyed digging in the sand and making sand castles.  I was worried, at first, about how that would affect her skin, but it turned out that it was like having a sea salt scrub spa treatment!  Her skin looked amazing at the end of our trip!  I thought she might have been troubled by the high salt content in her open splits on her fingers, but she was having too much fun to even care and never said a thing about it!  I was really impressed.  Now, I will say that I had to prep her skin with lots of Aquaphor ointment, beforehand, to protect it, because we went out once without it and it did get irritated, but as long as I remembered to do that each time, her skin came out looking renewed and fresh.  My husband and I have discussed taking more frequent trips to the beach, just based on the wonderful effect the beach had on her skin, aside from the enormous amount of fun she had!

Marcie Mom: Thanks Selena for taking time to share your journey on your daughter’s eczema and beach holiday. There are many beaches in Malaysia and Singaporean and Malaysian parents reading this may be motivated to take up your tips and head down to a beach!

Categories
Living with Eczema

SOMEONE has Eczema and managed Make-up

Erica Cheung, NYU student who has written for Huffington Post shares her make-up, beauty journey.
Erica Cheung, NYU student who has written for Huffington Post shares her make-up, beauty journey.

This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Erica Cheung, who has eczema for three years and shares how she manages her make-up. I first learnt of Erica’s eczema while reading her story on Huffington Post. Erica writes for Huffington Post and a senior at NYU. 

Marcie Mom: Hi Erica, thanks for being the first guest for this new series ‘Someone has Eczema’! This blog has been focusing on expert advice for two years, and now I think it’s time to spotlight on individuals coping with eczema as our readers are already knowledgeable in eczema. How long have you had eczema, and has it affected you more during a certain stage of your life?

Erica: I’ve had eczema for three years since I was a sophomore in college. At first, I wasn’t sure what was happening to me but I couldn’t take hot showers anymore without feeling itchy and I started noticing red patches of skin on my neck. Developing eczema in my early years of college was tough not only because it was uncomfortable and unattractive, it added to the stresses I already had as a hardworking student/intern/part-time employee. I researched online about my condition and although I learned a lot about eczema, I really felt like I was one of a handful of people suffering with this condition. This is why I’m so excited about your series ‘Someone has Eczema’!

Marcie Mom: I see in this post that the Huffington Post loves your beauty wisdom. I’m someone who hasn’t put on makeup more than ten times, and one of them was on my marriage! So, can you share your make-up tips (like when you change your brush and what else? I’m clueless in this!)

Erica: As a style/beauty blogger, I love experimenting with makeup and nail polish (especially on holidays!) which is why I was really bummed when I developed eczema and realized that most of the makeup I was using irritated my skin and eyes. My advice when negotiating makeup and eczema is to find a beauty regimen that suits your skin. It really starts with having happy skin. I make sure to use a moisturizer that uses natural ingredients and is highly moisturizing but also calming. My skin is extremely dry and sensitive. It’s always great to ask your dermatologist what skin products he/she recommends and it’s very important to know what suits your skin type. I always recommend Lush’s products because they’re all natural and handmade, so it is easy to know what exactly you’re putting on your skin.

Once your skin is calm and ready for makeup, the next step is to find a good foundation. Again, I always look for natural makeup lines that use as many non-synthetic materials as possible. Two good makeup lines to look into are Tarte and Bare Essentials. Always let the person at the makeup shop know that you have eczema and that you’re looking for makeup that is nourishing and natural and that also doesn’t clump up and get cakey. Cakey foundation is our enemy.

In terms of eye makeup, I learned the hard way that mascara and black eyeliner are the two most irritating products someone with eczema can use. That is, of course, if you’re using products made from harsh ingredients like coal or synthetic formulas. I use Tarte’s Lights, Camera, Lashes and it works like a charm without irritating my tear ducts (it also makes my lashes look amazing!) I’ve also found that Lush’s Emotional Brilliance makeup line is absolutely fantastic for eyeliner choices because they’re all-natural and can easily be washed off with water.

The only other makeup advice I can give is to make sure to remove makeup at night and use a soothing night moisturizer. In terms of scalp problems, I had a hard time finding products to soothe my scalp. Eventually what helped was taking Evening Primrose Oil and trying my hardest not to scratch. Also, natural shampoos seemed to soothe my scalp way more than other shampoos with chemicals in them (again Lush has an amazing selection). If you have any other questions about specific issues or advice please email me

Marcie Mom: For those with facial eczema, do refer to Dr Lynn Chiam’s advice on various types of rashes on face and rashes around the mouth and lips.

Erica, what is your skin care routine for your face? Do you moisturize and do you apply any topical treatment creams on any part of your face?

Erica: I briefly mention this above. I use skin care treatments with all natural ingredients. I wash my face in the morning with water and twice a week I use a light exfoliator from Burt’s Bees. I then use a moisturizer called Celestial for sensitive skin from Lush. I only apply topical treatment creams when I flare up. If I am flaring up, I try not to put anything on my face and apply treatment creams until the flare passes (I also take a antihistamine and drink green tea). I don’t use toners because they tend to dry my skin up too much.

Marcie Mom: One final question – on the dreaded day of eczema flare, and should you fall on a day that you think you ought to have makeup on, what do you do?

Erica: I would take a strong antihistamine (I take Allegra) and then wash my face with no exfoliator at all. I would then apply my trusty moisturizer (its very important to find a moisturizer that you love that soothes your face no matter what) and go with a more natural look. Choose a bold lip (pinks, reds, oranges) and apply neutral eye shadow colors (which contain less synthetic ingredients to begin with). Curl your eyelashes but apply no mascara and go with a light eyebrow pencil. The bold brow and lip with draw attention away from the rest of your face and the eye shadow with give you an elegant but natural look. I would finish off by applying topical creams when needed and waiting for the flare to pass to apply foundation and mascara.

Marcie Mom: Thanks Erica for being my first guest and sharing your personal journey, with makeup and eczema – your sharing confirms I’m right to start this series, I’d never be able to advice anyone on make-up! (Maybe I ought to try make-up someday too, sounds fun!)

Categories
Eczema Facts

Should you be Worried about House Dust Mite (HDM) for your Eczema Child?

House Dust Mite (picture from dust-mite.net)

House dust mites are tiny insects, about 0.03mm long, look scary under a microscope but too small to be seen by us. They are definitely in our homes as house dust mites, or HDM, love room temperature (18 deg C to 26 deg C/65 to 80 deg F), humid (above 55%) homes where there are plenty of shed human skin for food. HDM feed on our dead skin, fingernails, hair, animal fur, bacteria, fungi and pollen. In your home, they are likely to be on the bed, mattress, carpets, upholstered furniture and curtains. There is no way to have zero dust mite in your home, but you can reduce their quantity by making the environment less favorable for them. It takes a lot of effort to keep the dust mites away, so we should understand a little bit more before killing ourselves with the cleaning.

How does house dust mite affect your eczema child?

First things first, get your child tested. A skin prick test will show if your child is allergic to the droppings of the house dust mite. It’s the protein in the droppings that is the allergen, and not every eczema child will be allergic to HDM (my baby Marcie isn’t) though patients with eczema could be more susceptible to dust mite allergy (taken from “Specific profiles of house dust mite sensitization in children with asthma and in children with eczema” article in Pediatric Allergy and Immunology 2010). It was also written in the same article that those with eczema by 3 months old is more likely to be sensitized to aeroallergen by 5 years old. Also, the more severe the eczema, the greater the sensitization to HDM. In the article, it is noted that the major HDM allergen for eczema patients is Der p1 of D.pteronyssinus, which is a large particle that don’t stay airborne but quickly land on surface, including on the skin. For eczema children with defective skin barrier, the allergen can penetrate the skin more easily to trigger itchiness.

How to reduce house dust mite?

If your child is tested allergic or get asthma attack from inhaling the HDM allergen, then there’s little choice but to get rid of as much dust (and the dust mite dropping trapped in the dust) as possible. Here’re a few ways to keep the dust mites away:

1.      Remove carpets, thick curtains, thick mattress, upholstered furniture (think plastic, wood, leather, vinyl).

2.      Get dust mite proof covers for the pillows and mattresses.

3.      Wash bed sheet, pillow cases weekly at temperature of above 60 deg C (you can see my washing machine here, I steam wash everything).

4.      Wipe your home with wet cloth, instead of dry dusting from one area to the air (finally, there’s some support for what I love to do, using a wet kitchen towel to clean everything).

5.      If vacuuming, get a vacuum cleaner with a good filter that does not release small particle in the exhaust; I borrow my friend’s $3000 vacuum cleaner twice a year to vacuum mattress; but if your child has asthma, then the mattress needs to be vacuum weekly. (Dust mite can burrow deep into the mattress and will be hard to vacuum away if the mattress is thick.)

6.      Ventilate room; this will reduce stale humid air trapped in the room, and let the sun in (think less cosy for the dust mite).

7.      No soft toys; if your child absolutely can’t do without them, try freezing the soft toys in plastic bag for 24 hours in the freezer to kill the dust mite, followed by washing away the dead mites and droppings in the washing machine.

8.      Reduce humidity, but too dry environment is bad for eczema, read this post on humidifier and air-con.

9.      Reduce ornaments, dried flowers, books, textured wallpapers; the less surface for dust to land on, the better.

Save your money on these:

1.      Don’t buy mite killing sprays which may be an irritant; likewise, for ionizers.

2.      Don’t buy air filters because the air filter may stir up air, making it longer for the dust to settle (which increases risk for asthma children as the HDM allergen stays airborne). Or air filter may end up filtering only the air near to the filter.

Categories
Eczema Facts

4-part series on What Causes Your Child’s Eczema – Allergy

Role of allergens according to age and severity of AD (taken from Table 3 of article “Features of childhood atopic dermatitus”

This is a 4-part (a little more technical) series inspired by a review article “Features of childhood atopic dermatitis” by Hugo Van Bever and Genevieve Illanora. The article summarizes 4 players involved in atopic dermatitis, and I’ve tried to understand whatever I could from the article and hopefully digested the information accurately for you to read.

Does Allergy Cause Eczema?

The answer is we don’t know. If you refer to the first part of this series, allergy is hypothesized to be caused by eczema (rather than causing eczema). What has been observed is that the more severe eczema is, the higher the chances of allergies (as shown in table above). Allergies can be to food (which in the article “Features of childhood atopic dermatitis” summarized that it can be from direct eating/drinking, breast milk, placenta, inhaling and even kissing!), to house dust mites, dander and a whole lot of others (I’ve freaked myself out when researching what my baby girl Marcie could be allergic to).

Marcie’s Allergy

As it turned out, Marcie is not allergic to anything! She had a skin prick test done, something which I always recommend other parents to do because it takes a lot of guess work out. True that skin prick test is not 100% fail-proof, but it’s better than going mad worrying about everything cos if you google, you will most surely find something written or a post by someone that their child is allergic to something.

Here are some previous posts on skin prick test and eczema triggers that may interest you:

Taking the fear out of skin prick test

What triggers itch?

If your child has eczema, can you have a pet dog?

Is partially hydrolysed milk worth the money?

What and how much Detergent to Use?

Is it what you ate? How pregnancy diet affect eczema in baby

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Eczema Tips

What and how much detergent to use when you have a child with Eczema?

My washing machine

When you are a first-time mom, you get lots of advice; if you are a first-time mom of an eczema child, you get even more advice on everything from everyone, and sometimes they get contentious. Detergent is one of the issues where opinions differ – some say no detergent, some say little detergent, some say organic detergent and most of the time, it brings about frustration. So what is right?

Unfortunately, yet again, there is no clear cut answer. Detergents are everywhere, from laundry, to residue on our clothes (supposedly up to 2% of the fabric weight), towels, dishes, food containers, bedding, bathroom, floor, furniture, hair, skin (ours that come into contact with our children) and lint. There are parents who believe in cutting out all sources of detergent but given the prevalence of detergent even in dust, it is difficult to cut everything.

Below are some of what I’ve found out, from various research papers and online.

1. Increase in eczema is linked to increased usage of soap and detergent personal wash products in children (taken from review article Features of childhood atopic dermatitus by Hugo Van Bever and Genevieve Illanora, who in turn quoted Dr Michael Cork’s 2002 article)

Dr Michael Cork’s article in Dermatology in Practice published that eczema in british children increased from 3% in 1950s to more than 20%; during this time, the sales of detergent increased from 76m pounds in 1981 to 453m pounds in 2001. There is also an increase in central heating, carpeting, double glazing/wall insulation that promotes the environment for dust mite to thrive.

2. Is detergent bad?

Apparently, yes. Detergent strips the protective fats of our skin barrier, making it easier for irritant and allergen to penetrate. Eczema skin is dry, and thus more suspectible to cracks in the skin, making it even more vulnerable. The ingredients which are bad in detergent include sodium lauryl sulfate, triclosan, formaldehyde, sodium hydroxide, linalool and sodium flouride. These chemicals are not only used in detergent (including some hypoallergenic detergent), but also fabric softener, bubble bath, insect repellent, air freshener, toothpaste, bleach, liquid soap and baby wipes!

(A Sweden study showed that 5–7% of 3,000 eczema patients patch tested positive to linalool, which is found in 60-80% of perfumed hygiene products and detergent liquid. Linalool is a fragrance ingredient found naturally in lavender and mint, and when oxidised, can cause contact allergy).

3. So what to use and how to use?

Mild, fragrance-free, dye-free, lubricant-free, phosphate-free, brightener-free products suited for sensitive skin. (many webpages recommend puraderm). Recommended to use liquid detergent, instead of solid and to use 1/8 to 1/2 of the recommended dosage (supposedly washing machines are more water-efficient now while detergents have gone more concentrated). Using more detergent than necessary does not make your clothes cleaner but instead creates a build-up of residue which you can tell if your clothes get stiff when dried.

4. So how far should you go in cutting down detergent?

Personally, I used as little detergent as I can pour out and I invested in a washing machine with allergy care function which supposedly washes away chemicals, which I think it does as each cycle is 2 hours! I clean my floor with water only and that’s about all the measures I take. I find cutting all traces of detergent to be too exhausting and so far it hasn’t seem necessary from observing my baby’s skin reaction. What’s your take on this? Do drop me a comment!

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101 things that Mothers with Eczema Child do Differently

7 of the 101 things that Moms with Eczema Child do Differently – Detergent Decision

Detergent Decisions

I remembered that detergent was one area which I received lots of ‘advice’ on, especially when Marcie’s skin was very bad about 7 months old. It’s frustrating, and that’s one of the reason I’ve set up the support group because only parents with eczema children go through all the other stuff that comes with eczema flares.

This is the seventh of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.

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Support Group

If your Child has Eczema, can you have a Pet Dog?

It all depends on whether your child is allergic to pet dog dander/hair and you can find that out by getting your child tested, usually through a skin prick test or blood test. If your child is tested allergic, then the best way to avoid triggering an eczema flare is to not have a pet dog. There’s website offering information that certain dogs are hypoallergenic because they have less hair/dander but studies have debunked that correlation.

Bedlington Terriers

If you have a pet dog, there are a number of ways to reduce the chances of your child coming into contact with the pet dog’s dander/hair:

By Keeping the Pet Dog Dander/Hair out of the House and the Air

By keeping the dog outside of the house and off the furniture, at least off your child’s bedroom

By minimizing materials that trap animal dander such as carpets and curtains, upholstered furniture, wool bedsheets (best if you have polished floor, plastic/wooden furniture and cotton sheets)

By removing airborne animal dander by using HEPA air purifier

By vacuuming frequently using a Miele or another HEPA filtered vacuum cleaner (my colleague’s daughter’s allergy specialist recommended Miele brand and I see it being recommended on most sites)

By Reducing the Pet Dog Dander/Hair that your Dog Shed

Wash your dog at least weekly with dander reducing shampoo

Wash your hands thoroughly (remembered watching on ‘The Doctors’ that a test done on various items of a dog owning family revealed dog poo even on the owner’s wallet)

The Good News…

The good news is that a study conducted by Dr. Tolly G. Epstein suggest that children who have an allergy to dogs AND who have exposure to dogs before the age of one year old has a lower chance (14% vs 57%) of getting eczema by age four years old, compared to children with a dog allergy and did not have a pet dog. (note to cat lovers: It’s the reverse, i.e. more likely to develop eczema after having a cat if already have a cat allergy 54% vs 33%)

And the other good news is that children who don’t have a dog allergy won’t develop one after having a pet dog (is that true? didn’t see this published much, anyone has experience?)

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Other treatments

Is it what you ate? How Pregnancy diet affect eczema in baby

Citrus Fruits

“OH NO, could it be what I ate?” This was what went through my mind when I first read that pregnancy diet could increase the chance of my baby getting eczema (and my baby girl Marcie has eczema since two weeks old). I am not writing this post to put more guilt and blame into your life, but rather, if you’re considering a next child, it will be good to avoid some food or increase the intake of others. There is no conclusive evidence despite some scattered research reported on the web, so the overriding consideration is still to have a balanced diet (because a diet that is not balanced can lead to a whole host of other problems in the foetus and mothers who restrict their diet have resulted in smaller babies).

Here are some food to avoid:

1. Margarine; vegetable oil (too much will be too fat anyway)

2. Citrus fruit; celery (I ate lots of oranges during my pregnancy! Then again, my hubby has eczema so it’s more likely hereditary than diet)

3. Peanuts (Again, I ate peanut butter every morning! If your child has eczema or allergy, the advice is to delay giving peanuts till 3 years old)

4. No smoking or alcohol

Results of 2007 German study of 2,641 children is that food rich in n-6 polyunsaturated fatty acids and citrus fruits increase eczema in children up to 2 years old, whereas food rich in n-3 polyunsaturated fatty acids decrease chance of infant eczema. A later Japan study in 2010 shows that green and yellow vegetables, citrus fruit and beta-carotene reduces chance of infant eczema. (So citrus or no citrus?)

Here are some food to increase:

  1. Fish or fish oil
  2. Lactobacillus reuteri as oral probiotic supplement (my friend with eczema was prescribed this during pregnancy and both her girls turn out with no eczema)

Personally, I will eat more fish, take the probiotic supplement, not eat so many oranges nor peanut butter in my next pregnancy. I know how scary it is thinking our next child will also have eczema, fingers crossed..

Update: Almost 2 years later, we’ve decided not to have another child BUT more importantly, linking this article to a Q&A that I did with nutritionist Judy Converse on breast milk and pregnancy diet.

Update for a study in October 2014 that studied associations between maternal iron status in pregnancy and childhood wheeze and atopy. The results suggest that reduced maternal iron status during pregnancy is adversely associated with childhood wheeze, lung function and atopic sensitisation, justifying further studies on maternal Fe status and childhood asthma and atopic disease.

Update for a study in Nov-Dec 2014 that looked at all past studies Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches. Conclusion was did not find widespread or consistent links between mothers’ dietary intake and atopic outcomes in their children. However, maternal consumption of Mediterranean dietary patterns, diets rich in fruits and vegetables, fish, and vitamin D-containing foods were suggestive of benefit, requiring further evaluation.

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Eczema Tips

Keeping Cool with Air-Con and Staying Moist with Humidifer

Humidifier

Heat and perspiration is the most common trigger of eczema and that’s exactly what gets my baby Marcie scratching. To keep the room cool, especially when it’s summer all year round in Singapore, you would have to on the air-conditioner. However, that makes the air dry and from experience, I realized that a humidifier did help my baby to sleep better. Here’s various pros and cons of a humidifier.

Pros

Helps combat dry skin, caused by air-conditioning. Dry skin is prone to irritation and lead to scratching. Doctor Claudia Aguirre commented in 2012’s twitterverse 1st Eczema twitter party hosted on this blog that should the humidity falls below 40%, moisture will start to strip away from skin, for full twitter party transcript see here.

Cons

Dust mites thrive in humid environments, so if your child is tested to be allergic to dust mite, you would need to find the right level of humidity to get the air moist, without encouraging dust mite to thrive (usually 30% to 50% humidity)

Too humid environment encourages growth of mold, which may be a possible trigger of eczema

And as I always emphasize, it is important to have your child tested to know what triggers the eczema. You can check out my Top 10 Eczema Tips and posts on Skin Prick Test and Itch Triggers.

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Other treatments

Is partially hydrolysed milk worth the money?

Partial Hydrolysed Milk sold in Singapore

Partially hydrolyzed milk formula, such as Enfalac HA and NAN HA, was recommended to my baby girl Marcie when her eczema was diagnosed by the paediatrician at one month old. It was a nightmare getting her to drink the less tasty milk formula and each bottle feed dropped from 85ml to 20ml! It seemed to improve when we made the switch from NAN HA to Enfalac HA but you never know if it was due to the milk or that the reflux or gassiness got better.

The irony is that when I brought Marcie for a skin prick test when she was seven month old, she isn’t actually allergic to cow’s milk! The paediatrician had assumed that Marcie’s eczema was caused by food allergy, when it was intrinsic. So, I began to google whether HA milk was worth the money and whether I should let my next baby have hydrolyzed milk from the start.

So, here’s what I’ve found on this:

1. Partially hydrolyzed milk is non-hypoallergenic

This really confused me since the label clearly stated hypoallergenic. However, it seems like unlike extensively hydrolysed milk (which is not available in supermarket), only part of the cow’s milk protein is broken into smaller pieces.

2. Partially hydrolysed milk is proven to reduce risk of food allergy

So far research suggests that partially hydrolysed milk reduced the risk of food allergy, but it is not recommended for babies which has a firm food allergy. That is, if your child is already tested allergic to milk, giving partially hydrolysed milk can still give rise to allergic reaction.

3. Everyone says the best is breast milk

Naturally, it is cited on all labels that WHO recommends breast feeding for first six months. Problem is, parents like you and I, who are already stressed out with dealing with babies with eczema are unlikely to have the rest or the time to drink fluid or have proper nutrition, to produce enough breast milk! Easy to say, but we all know the effort required to produce breast milk.

I think, given that eczema is hereditary and to spare myself from the trauma of switching baby’s formula from a normal sweeter one to a partially hydrolysed one (should my next baby also has eczema), I would just start off him or her with HA milk.

Update: I’ve interviewed nutritionist Judy Converse on partially hydrolyzed milk about 2 years from this post (time flies!) and click here to read her explanation. Also check out this post in 2015 that compiled the significant studies on partially hydrolysed milk’s preventive effect for eczema high-risk infants.

Categories
Eczema Tips

How to Shower your Eczema Child?

Having fun in water

Even a simple task like bathing can generate lots of different views. If you read online, you will find some people saying that children with eczema should bathe every few days while others say that up to 3 baths a day is acceptable. From what I understand from Marcie’s doctor, the important thing for bathing is to moisturize immediately after shower. As a quick guide, below are my top 5 FAQs on showering baby with eczema:

FAQ 1: How often to shower baby?

The general guide is not to lose moisture through showering but to retain or increase moisture from the routine. Frequent showering will lose moisture but for babies whose itch is triggered by heat and sweat like Marcie, she showers about twice a day. Once in the morning to get her off to a fresh start and once before bedtime to (hopefully) reduce scratching at night.

FAQ 2: What water temperature for the baby bath?

Lukewarm is recommended; warm is a no-no, again due to loss of moisture. Heat actually temporarily numbs the skin and reduces sensitivity of the itch nerves (from what I read). However, its permanent effect is a loss of moisture.

FAQ 3: What bath lotion to use?

Soap-free and perfume free. I use Dermaveen Colloidal Oatmeal bath oil (you can also try Aveeno’s) which is soap-free, moisturizing, non-greasy, lower skin pH and seals the moisture after baby’s bath.

FAQ 4: How long to bathe?

Usually soak for 10-15 minutes. As your baby gets older, she may no longer fit into the bath tub or prefers to bathe standing. Now Marcie will sit in the bath tub if she has toys to play or we blow bubbles to keep her amazed and seated in the tub.

FAQ 5: What to do after shower?

Don’t slip if you have just used the colloidal oatmeal bath lotion!

Wrap baby in towel, pat dry, don’t rub towel against skin. Moisturize immediately (you can refer to this post on the choice of moisturizer).

Update: About a year and half after this post, I’ve interviewed Dr Jennifer Shu and you can refer to her advice for bathing for babies with eczema here.

Categories
Support Group

Top 10 Cooling Places to go with your child in Singapore

Having fun at Sentosa

We all love a good weekend outing and I’m sure if you are parenting a child with eczema, you would have figured that the stress level can hit sky high if your child is scratching.

First and foremost, you would have to figure out what triggers your child’s itch. For my baby Marcie, it’s the heat and sweat and Marcie’s doctor has told us to keep her fresh all the time. So a cooling place, well ventilated, preferably air conditioned is my top priority. After bringing Marcie out from one month old till now, 17 month old, here are my top 10 cooling places to go.

1. IMM – Apart from free parking for the 1st 3 hours, the place is huge enough that even on a weekend, the crowd has not ‘crowded out’ the cool air. There are also bookstore, toy stores and children stores with children rides around the mall. The latest addition is a 7-meter tall tree house playground at level 3. Fish & Co and Café Cartel have aircon that is cooling enough and also serve kids meal.

2. Libraries – Here you have to try out which library is cooling enough. For me, Bukit Banjang and Jurong West libraries have strong aircon but Jurong East’s aircon is too warm plus the children section in the basement have quite stale air. One drawback of libraries is that there is no diaper changing area.

3. Tanglin Mall – This mall is not crowded and have many children stores plus an organic shop that also sells baby food. Marcie could even eat in the food court as it is well air-conditioned. From Tanglin mall, you can walk to Forum the Shopping Mall which also has many children stores and Toys R Us.

4. Ikea – Though crowded over the weekend, Ikea has shopping trolleys that have child safety belts. Marcie loves sitting in the trolley so even if it is crowded, she can be distracted enough not to scratch. The dining area is always crowded but fortunately, there is a mini playground to keep Marcie busy.

5. Vivocity – Marcie loves the fountain and we let her play in it once. There is a baby changing area inside the female toilet, located very near to the entrance facing the fountain. The food court is far too stuffy and warm, don’t venture there if your baby itches when hot.

For outdoor places, it really depends on the weather. So far, we have brought Marcie to the following places where she didn’t scratch much.

6. Singapore Zoo – We went on a rainy Saturday and though it’s crowded, Marcie was attracted to the animals and the show and didn’t scratch.

7. Sentosa

Playing with the mist at Sentosa

We went on a crowded flower festival event over the Chinese New Year. It turned out well as we took a break in the air-conditioned visitor centre plus let Marcie play with the mist that comes out from the ground. The climb up to the cable car station is torturous though with throngs of people wanting to go up the escalators.

8. Qian Hu Fish Farm – This is cooling since the fish need a cool environment. Everywhere is sheltered and your child will likely be amazed with the range of fish. Some will even follow your finger on the tank and it’s quite fun for Marcie! The canteen can get fairly warm on a hot day though, so don’t plan your meals there.

9. Hay Diaries Goat’s Farm – The goat farm has milking time in the morning when the goats will be brought up a ramp to the milking area where the staff will pump the milk. It’s fascinating to watch and it’s also sheltered with a ceiling fan. Feeding of goats is no longer allowed but you can still walk around to view the goats from a distance.

10. Jacob Ballas Children Garden – There is a little fountain for children to play but it’s not shaded. Though suitable for kids who can walk and climb very well (there is a tree top house), I suggest giving this a miss on a hot day.

Categories
Eczema Facts

What Triggers Itch?

Scratch marks on knuckles and knees

In my page on eczema tips, one of the most important step is to “know the triggers in order to control them“. I feel that this is very crucial, because it takes a lot of guesswork (and stress out) of managing your child’s eczema. I remembered that at one time when Marcie started on solids, I got soooooo paranoid that everywhere I looked, I saw potential triggers. A skin prick test eliminated a lot of what I thought might be a trigger, thus immediately reducing a lot of anxiety relating to cleaning the house and monitoring food allergy (which both Marcie tested negative to). So what are the common triggers? In order of highest probability (extracted from the book “Eczema Free for Life”):

1. Heat and Perspiration 96%. Heat is the ONE thing that I’m most afraid of. Even in an air-conditioned restaurant where not-so-cold air comes out from only certain air vents, Marcie would scratch her neck out before we even ordered the meal.  Don’t be afraid to walk into a restaurant and ‘feel the air’ and ask for the coolest seat. Sweat contains chemicals that may trigger itch, so keep your baby fresh all the time. Sudden changes in temperature or humidity may also be a trigger.

2. Wool 91%. Scratchy fabrics are to be avoided, including nylon and polyester, which may irritate the skin. Wear light cotton for your baby.

3. Stress 81%. Baby gets stressed too, so let your baby have a routine and keep her occupied with toys. I co-sleep with my baby as I feel it reduces her stress too.

4. Spicy food/ hot beverage 49%. I know this is going to be controversial – I give Marcie cold baby fruit juice from fridge. My parents and the infant care teachers freak out at this and blamed a lot of Marcie’s problems on cold drinks. But I know she’s happy and almost immediately stopped scratching and took her mind off the itch. When I’m out, I may buy her a cold drink just so she can hold the cold bottle (it works!). For the record, I read that the only negative impact of cold drinks/food is that the baby takes more energy to digest them, thus reducing the energy left for your baby’s body.

5. Alcohol 44%. Not an issue with children but don’t apply alcohol on your baby’s skin though it’s cooling when the alcohol evaporates. It may dry her skin further. Drinking alcohol is of course a no-no. It expands the blood vessels near the skin, causing the skin to be more sensitive.

6. Cold 36%. I’m not sure about this one – whether the cold triggers the itch or simply a baby with cold feels cranky and scratches.

7. Dust mite droppings 35%. Marcie is tested to be not allergic to dust mite droppings but I still steam her clothes and the bed sheet, pillow cases in hot water to kill the dust mite. (Please buy a good steam washing machine if you like to do this; boiling water yourself and soaking the clothes take too much of the little time you have).

More possible triggers below:

Soap, perfume, laundry detergent. I use soap-free bath oil for Marcie, nothing she uses is perfumed and the laundry detergent is children-friendly. Plus my washing machine has an allergy function that washes off the chemical in the detergent thoroughly.

Chlorinated water. Bathe and moisturize after swimming, check out this post.

Pet fur. Marcie is tested not allergic to dog’s and cat’s hair. Do get your baby tested too. Plus pets bring in lots of allergens from outside the house, do keep them at least out of your baby’s bedroom.

Mold. Marcie is tested not allergic to mold too. Do get your baby tested.

Saliva. This is quite a common irritant for even non-eczema children. Baby’s cheeks and areas around the mouth usually get red with rashes due to constant contact with saliva, especially when they start teething and playing with their saliva! I use cool boiled water to wipe Marcie’s face before her bedtime.

Food. Though food is the most worrying for most parents, it is seldom the trigger. Marcie is not allergic to peanuts nor cow’s milk or egg, but the doctor’s advice is to wait till one year old to try these food. Mango is another fruit that many people balked at me for letting Marcie eat, citing that it is a ‘heaty’ food. I read somewhere later though that the area around the mango skin may cause itch, so just take care to let your baby eat the flesh inside. Mango is a very good fruit with vitamins, don’t ignore it and baby loves them with yoghurt!

Final point – do a skin prick test. Don’t guess and drive yourself crazy.